CMS releases proposed rules on Outpatient and Physician Fee Schedule

On Thursday, July 13, the Center for Medicare and Medicaid Services (CMS) released two new Notice for Proposed Rulemaking (NPRM).

The first NPRM released, the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, reflects the broad strategy by CMS to relieve the regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility and innovation in the delivery of care. Within the proposed rule, CMS is releasing within the proposed rule a Request for Information to welcome continued feedback on flexibilities and efficiencies in the Medicare program.

The second NPRM released was the Revisions to Payment Policies under the Physician Fee Schedule (PFS) and Other Revisions to Part B for CY 2018. Through the proposed rule, CMS hopes to provide greater potential for payment system modernization and is looking for public comment on reducing administrative burdens for providing patient care, including visits, care management, and telehealth services. This rule also take steps to better align incentives and provide clinicians with a smoother transition to the new Merit-based Incentive Payment System under the Quality Payment Program (QPP). There are limited expansions of telehealth services covered, with a request for comment on other services that should be included in future reimbursement. CMS reminds stakeholders that suggested expansion will be considered for inclusion two years after requested.